HUMAN PAPILLOMAVIRUS INFECTION AND THE SIZE AND GRADE OF CERVICAL INTRAEPITHELIAL NEOPLASTIC LESIONS ASSOCIATED WITH FAILURE OF THERAPY

OBJECTIVE: This investigation was designed to identify specific risk f actors associated with treatment failure for cervical intraepithelial neoplasia. METHOD: A cohort of 436 women was assessed for the presence of cofactors associated with therapy failure. The risk factors includ ed the HPV infection status of the patient, a previous history of geni tal condyloma and the size of cervical lesions. RESULT: The treatment outcome was not related to the treatment modality (P = 0.058). Thirtee n (8.1%) women failed laser therapy, while 15 (5.4%) women failed cryo therapy. While treatment failure occurred only in the presence of HPV infection (P = 0. 036), failure was not related to infection by a spec ific genotype. Therapy failure was associated with treatment for CIN I I (RR 4.157) and CIN III (RR 2.053) relative to CIN I and treatment of large lesions (P = 0.014). CONCLUSION: The determination of the relat ive area occupied by cervical lesions may have prognostic value in ide ntifying women who are at risk for treatment failure.